...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >A systematic review of adjuncts for intravenous regional anesthesia for surgical procedures.
【24h】

A systematic review of adjuncts for intravenous regional anesthesia for surgical procedures.

机译：静脉局部麻醉手术辅助方法的系统评价。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

PURPOSE: To review the use of adjuncts to intravenous regional anesthesia (IVRA) for surgical procedures in terms of their intraoperative effects (efficacy of block and tourniquet pain) and postoperative analgesia. SOURCE: A systematic search (Medline, Embase, reference lists) for randomized, controlled and double-blinded studies using adjuncts to IVRA for surgical procedures was conducted. Data were collected on intraoperative effects (onset/offset and quality of block and tourniquet pain), postoperative effects (pain intensity and analgesic consumption) and side effects recorded. Statistical significance as indicated in the original report and likely clinical relevance were taken into account to arrive at a judgment of overall benefit. PRINCIPAL FINDINGS: Twenty-nine studies met all inclusion criteria. Data on 1,217 study subjects are included. Adjuncts used were opioids (fentanyl, meperidine, morphine, sufentanil), tramadol, non-steroidal anti-inflammatory drugs (NSAIDs; ketorolac, tenoxicam, acetyl-salicylate), clonidine, muscle relaxants (atracurium, pancuronium, mivacurium), alkalinization with sodium bicarbonate, potassium and temperature. There is good evidence to recommend NSAIDs in general and ketorolac in particular, for improving postoperative analgesia. Clonidine 1 microg/kg also appears to improve postoperative analgesia and prolong tourniquet tolerance. Opioids are poor by this route; only meperidine 30 mg or more has substantial postoperative benefit but at the expense of postdeflation nausea, vomiting and dizziness. Muscle relaxants improve intraoperative motor block and aid fracture reduction. CONCLUSION: Using NSAIDs or clonidine as adjuncts to IVRA improves postoperative analgesia and muscle relaxant improves motor block.
机译：目的：就术中效果（阻塞和止血带疼痛的疗效）和术后镇痛方面，回顾静脉辅助区域麻醉（IVRA）在外科手术中的使用。资料来源：对使用IVRA的辅助手术方法进行的随机，对照和双盲研究进行了系统搜索（Medline，Embase，参考文献列表）。收集有关术中效果（发作/偏移以及阻塞和止血带疼痛的质量），术后效果（疼痛强度和止痛药的消耗）和副作用的数据。原始报告中指出的统计显着性和可能的​​临床相关性已被纳入考虑范围，以判断总体获益。主要发现：29项研究符合所有纳入标准。包括有关1,217个研究对象的数据。所用的辅助剂是阿片类药物（芬太尼，哌替啶，吗啡，舒芬太尼），曲马多，非甾体抗炎药（NSAID;酮咯酸，替诺昔康，乙酰水杨酸），可乐定，肌肉松弛剂（阿曲库铵，潘库溴铵，米曲库铵），碱化钠碳酸氢盐，钾和温度。有充分的证据推荐一般使用NSAID，尤其是酮咯酸，以改善术后镇痛效果。可乐定1微克/千克也似乎可以改善术后镇痛效果并延长止血带耐受性。阿片类药物在这条路线上很差。仅30 mg或更多的哌替丁具有明显的术后益处，但以放气后恶心，呕吐和头晕为代价。肌肉松弛剂可改善术中运动阻滞并帮助减少骨折。结论：使用NSAIDs或可乐定作为IVRA的辅助剂可改善术后镇痛作用，而肌肉松弛剂可改善运动阻滞作用。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号